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Abstract #80786 Published in IGR 20-3
Comparison of endothelial keratoplasty techniques in patients with prior glaucoma surgery - a case-matched study
Lin SR; Prapaipanich P; Yu F; Law SK; Caprioli J; Aldave AJ; Deng SXAmerican Journal of Ophthalmology 2019; 206: 94-101
PURPOSE: To evaluate the outcomes of Descemet membrane endothelial keratoplasty (DMEK) and Descemet's stripping endothelial keratoplasty (DSEK) in eyes with prior glaucoma surgery. DESIGN: ; Case-matched retrospective comparative case series. METHODS: Setting / Study Population: Forty-six DMEK procedures were matched with 46 DSEK procedures at a single institution. OBSERVATION PROCEDURES: Cases were matched based on preoperative visual acuity, lens status and surgical indication. MAIN OUTCOME MEASURES: The outcome measures included visual acuity improvement, primary and secondary graft failure, endothelial rejection, intraocular pressure (IOP) elevation, and the need for additional glaucoma intervention. RESULTS: Best-corrected visual acuity (BCVA) improved by -0.89 LogMar in the DMEK group and -0.62 LogMar in the DSEK group (p=0.005) at one year follow up. Visual acuity was significantly better in the DMEK group at post-operative months 1, 3, 12, and at last follow up. The percentage of patients achieving 20/40 or better BCVA was higher in the DMEK group at all time points, notably 47% in the DMEK group vs 15% in the DSEK group at 1 year (p=0.002). Secondary graft failure was lower in the DMEK group (DMEK 0% vs DSEK 17%, p=0.006). Primary graft failure rate and air injection rate were similar. There were no differences in the rate of post-operative IOP elevation or in the need for additional glaucoma intervention. CONCLUSIONS: In complex eyes with prior glaucoma surgery, DMEK offers faster visual recovery, better final visual acuity, and a lower rate of secondary graft failure compared with DSEK during the first postoperative year and beyond.
Stein Eye Institute, David Geffen School of Medicine, University of California - Los Angeles: Los Angeles, CA 300 Stein Plaza Los Angeles, CA 90095 United States.
Full articleClassification:
9.4.11.4 Glaucomas associated with corneal surgery (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.11 Glaucomas following intraocular surgery)
2.2 Cornea (Part of: 2 Anatomical structures in glaucoma)
